Alterações de neuroimagem no parkinsonismo: estudo de cinco casos

Costa, Maria do Desterro Leiros da; Gonçalves, Lílian Regina; Barbosa, Egberto Reis; Bacheschi, Luiz Alberto

doi:10.1590/s0004-282x2003000300011

Cited by 4 publications

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References 26 publications

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“…(6) Outros distúrbios encontrados em indivíduos com a Doença de Parkinson são anormalidades nas aferências sensoriais e no processamento motor sensorial, (7,8) estes distúrbios constituem um fator importante no que se refere às manifestações de instabilidade em espaços abertos e controle postural deficitário. (7,8) A instabilidade postural em portadores da DP se deve também às mudanças posturais que são comumente encontradas nestes indivíduos.…”

Section: Introductionunclassified

Avaliação Postural Em Pessoas Com Doença De Parkinson: Estado Da Arte

Nascimento

Santos

Guerreiro

et al. 2016

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ResumoIntrodução: A doença de Parkinson (DP) é um distúrbio neurodegenerativo e progressivo, caracterizado pela apresentação de distúrbios motores. Ocasiona déficits nas aferências sensoriais que por sua vez, resultam em instabilidade no controle da postura. Objetivo: Sistematizar o conhecimento acerca das principais alterações posturais em pessoas com Doença de Parkinson. Material e métodos: Tratou-se de uma revisão de literatura. A pesquisa fora conduzida nas bases de dados eletrônicas da Pubmed, SciELO, Google Scholar e Science Direct. As palavras-chave utilizadas foram: "doença de Parkinson", "alterações posturais", "avaliação postural" e "fotogrametria"; nas línguas portuguesa e inglesa. Resultados: A busca resultou em 30 artigos aceitáveis. Foram excluídos 23 artigos que analisaram o controle postural e/ou instabilidade postural em pacientes com DP por meio da posturografia. Outros que avaliaram o equilíbrio, abordavam desvios no tronco ou apenas segmentos isoladamente, que tenham apresentado resultados referentes à análise postural de parkinsonianos após tratamento de alterações na postura também foram excluídos. Desta forma, sete artigos publicados nos últimos 10 anos, nos idiomas inglês e português, foram incluídos. Considerações finais: Identificou-se que há predomínio de alterações posturais no plano sagital com associação de uma postura arqueada.Palavras-chave: Doença de Parkinson; Postura; Fotogrametria; Envelhecimento.• Artigo submetido para avaliação em 24/12/2015 e aceito para publicação em 01/02/2016 To systematically arrange the knowledge on the main postural alterations in subjects with PD. Material and methods: A literature review was conducted using electronic databases from PubMed, SciELO, Google Scholar and Science Direct. The keywords picked were "Parkinson's Disease", "postural alterations", "postural evaluation" and "photogrammetry"; the search was conducted both in English and in Portuguese. Results: The initial search resulted in thirty papers found, but twenty-three of them were excluded because they evaluated postural control or instability using posturography. Papers that evaluated equilibrium, trunk deviation and segmental abnormalities were also excluded from the final analysis. Seven papers, published in English or in Portuguese in the last ten years were selected for the final analysis. Conclusions: There is a predominant sagittal plan postural alteration associated with an arched posture in subjects with PD.

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Section: Introductionunclassified

Avaliação Postural Em Pessoas Com Doença De Parkinson: Estado Da Arte

Nascimento

Santos

Guerreiro

et al. 2016

RPF

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Parkinsonism – other causes

Riley¹

2011

Handbook of Atypical Parkinsonism

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Imagens de ressonância magnética funcional em pacientes com doença de Parkinson submetidos à estimulação cerebral profunda

Arantes¹

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INTRODUCTION: Deep brain stimulation (DBS) is used to treat advanced Parkinson's disease (PD). Stimulation of the subthalamic nucleus (STN) is effective to improve the symptoms related to parkinsonism, but its mechanism of action remains poorly understood. Functional magnetic resonance imaging (fMRI) can be applied to study brain areas involved in motor activity, as a mean to better understand the effects of DBS. In this work we aimed to develop and test fMRI techniques to study DP patients treated with DBS. METHODS: We have initially performed tests to check the interference of the DBS in image quality and made adaptations that minimized the artifacts. After this initial phase PD patients were examined by fMRI in four different phases: during right hand movement (before surgery to implant DBS electrodes, after the surgery with the electrical stimulation turned off, and after the surgery with the electrical stimulation turned on the STN) and at rest with electrical stimulation turned on. In total, ten patients were examined, eight of them paired to matched normal volunteers. All tasks were performed in three independent sessions for each condition, using two types of runs: blocked (BK) and event-related (ER). The images were analyzed calculating the frequency of activation detected in 19 sensory-motor areas. Behavioral data during fMRI exams and clinical data were also recorded. RESULTS: There were no clinical complications due to fMRI exams. The modifications in the DBS procedure and post-surgical time to fMRI examination resulted in a reduction of the image artifacts. In the controls the ER runs showed more activity than BK in: supplementary motor area, right pre-motor area (pM), anterior cingulated gyrus (aCg), posterior cingulated gyrus (pCg), bilateral thalamus, and right putamen. During the dominant hand movements, when comparing ER and BK runs in PD patients there was no significant difference considering pre and post operative phases without electrical stimulation. When the electrical stimulation was turned on, BK runs showed more activation in the left primary sensory-motor cortex (SM1) compared to ER runs. In the rest state, when the electrical stimulation was turned on, there was more activation in the following areas: right cerebellum, left SM1, pCg, bilateral pM, left mesencephalus and aCg. There was clinical improvement in the patients, and the motor performance in the first post operative week, in the drug withdrawn phase as well as in the global evaluation after six months were correlated with the motor parameters recorded during the fMRI exams. CONCLUSIONS: we have developed a method for fMRI in PD patients with DBS, which enabled the following observations: BK runs showed increased frequency of activity in SM1 in PD patients with electrical stimulation turned on, while the ER runs showed more frequency of activation in normal volunteers in primary and secondary motor regions; the electrical stimulations in rest state produced activity detected in cerebellum, primary and secondary motor regions.

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Alterações de neuroimagem no parkinsonismo: estudo de cinco casos

Cited by 4 publications

References 26 publications

Avaliação Postural Em Pessoas Com Doença De Parkinson: Estado Da Arte

Avaliação Postural Em Pessoas Com Doença De Parkinson: Estado Da Arte

Parkinsonism – other causes

Imagens de ressonância magnética funcional em pacientes com doença de Parkinson submetidos à estimulação cerebral profunda

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